BACKGROUND OF THE INVENTIONThe present invention relates generally to magnetic resonance (MR) angiography, which is the MR imaging of an artery or like vessel carrying blood and other fluid. More particularly, the invention pertains to a method of acquiring MR data at each of a number of scan locations or stations, which are spaced along the peripheral vasculature of a patient. Data is acquired after an initial test bolus of contrast agent is injected into the patient and is timed as it travels along the vessel or other conduit, from station-to-station. After the bolus travel time is known, an exam bolus is injected and MR data is acquired at each scan station while the bolus is located there.
It is a well known practice in MR angiography to insert a volume of contrast agent, such as gadolinium chelate, into blood flowing along a vessel. The volume or mass of contrast agent is referred to as a bolus, and has the effect of shortening the T1time of the blood. Thus, an MR image of the blood, acquired by a fast gradient echo or similar technique, will show up very well with respect to adjacent stationary tissue of the vessel structure. It is also well known, when imaging a blood vessel of comparatively great length, to acquire MR data from a patient at a given number of stations or scan locations, which are located at intervals along the vessel. To acquire MR data at a particular station, the patient is selectively positioned with respect to an MR scanner, typically by moving a patient table. Data is then acquired from a series of slices taken through a region or section of the patient in the particular scan location or station. Thereafter, the patient is shifted, relative to the scanner, so that data may be acquired from another section of the patient, in another scan station. MR angiography employing this procedure in conjunction with an injection of a contrast bolus may be referred to as bolus chasing peripheral MR angiography.
At present, when a contrast agent is used in connection with a peripheral MR angiography exam, the first scan station is selected to be the section of the patient, along a vessel of interest, at which the bolus arrives first. When the scan at the first station is completed, the acquisition normally moves to the next scan station. However, the most appropriate time to move to the next station is not precisely known. For example, in the case of slow blood flow, the distal vasculature at the next scan station may not have had adequate time to fill with contrast material. On the other hand, if flow rate is greater than anticipated, the contrast agent may tend to move into stationary tissue adjacent to the next scan station, before data acquisition commences. In either case, contrast between moving fluid and stationary vessel tissue may be significantly reduced at the next scan station. Moreover, undesirable effects, resulting either from flow rate which is too slow or too great, may tend to become progressively worse as imaging proceeds to subsequent scan stations and as the total number of scan stations increases.
Further, since the maximum safe dose of the contrast material cannot be exceeded, the number of scan sections or stations that can be imaged is limited and if an image is acquired either too early or too late, with respect to the flow of the contrast image, the repeatability of the exam is limited by that maximum safe dosage. Also, the coil must either be repositioned or switched manually such that the active elements are in the region of the imaged scan station. Consequently, the time required to complete a conventional peripheral MRA study is of the order of 1.5 to 2.5 hours.
It would therefore be desirable to have a method and apparatus that is capable of optimally imaging the peripheral vasculature that includes computer control over table motion and coil selection and obtain images at locations where it is known that the contrast bolus is present.
SUMMARY OF THE INVENTIONThe present invention provides a method and apparatus for optimal imaging of the peripheral vasculature that includes computer control over patient table motion and coil selection such that the signal-to-noise ratio (S/N) can be optimized at each of a number of scan locations that solves the aforementioned problems. The coordination with table motion allows accurate reproducibility of the different scan locations, thereby permitting optimal subtraction of a pre-contrast image mask from images obtained after the contrast bolus has been introduced. The method described is designed to pursue the passage of a bolus injection from the aorta down to the arteries in the lower extremities to acquire images of the arterial phase. Subsequent image acquisitions and mask subtractions can also allow post-processing of the data to generate venous phase images.
In accordance with one aspect of the invention, a method of MR imaging peripheral vasculature of a patient includes defining a given number of scan stations, with each of the scan stations positioned along the patient's peripheral vasculature, and initially injecting a relatively small amount of contrast agent into the patient to initiate the passage of a test bolus through the patient's peripheral vasculature. The passage of the test bolus is then tracked through the patient's vasculature from one scan station to the next and the patient is moved fore and aft in the MR imaging apparatus to position the patient such that a desired scan station is within a field-of-view (FOV) of the MR imaging device based on the passage of the test bolus. The method also includes determining a travel time that it takes the test bolus to travel through each of the given number of scan stations, and thereafter, injecting additional contrast agent to form and pass an exam bolus through the patient's peripheral vasculature. By using the test bolus travel time for each scan station, the passage of the exam bolus can be pursued through the patient's peripheral vasculature and data can be acquired in each scan station during a period of time while the exam bolus is present.
In a preferred embodiment of the invention, the test bolus travel time to each station is initially determined. During the regular image acquisition phase of the MR exam, a pre-defined central k-space data block is acquired at each station in a time determined by the test bolus travel time to each station. If the test bolus travel time exceeds that for complete data at each station, the additional time is utilized by either acquiring additional higher k-space spatial frequency encoded data to improve spatial resolution, or to re-acquire the central k-space low spatial frequency data in order to improve image signal-to-noise ratio (SNR). Missing k-space data in each station, if any, would then be acquired at the end of the scan.
In accordance with another aspect of the invention, an MR system is disclosed that is capable of optimizing imaging of the patient peripheral vasculature and includes an MRI apparatus having a number of gradient coils positioned about a bore of a magnet to impress a polarizing magnetic field and an RF transceiver system, and an RF modulator controlled by a pulse control module to transmit RF signals to an RF coil assembly to thus acquire MR images. The MRI system of the present invention also includes a computer programmed to ensure placement of a movable patient table within the MRI apparatus and in a first scan station of a pre-defined given number of scan stations, and upon an indication that a test bolus has entered a given scan station of a patient, the computer is programmed to track the test bolus through that given scan station and record a travel time of the test bolus through that given scan station, then initiate patient table movement to a subsequent scan station. These steps are repeated for each subsequent scan station, and once complete, the computer returns the patient table to the first scan station. Upon an indication that an exam bolus has entered the patient, the computer activates the MRI apparatus to acquire at least central k-space MRI data of the patient within each of the scan stations for a period of time substantially equal to the test bolus travel time for that particular scan station, as previously recorded using the test bolus.
Accordingly, the method and apparatus of the present invention is used to control table position and move the patient from one scan station to another, and control coil element selection and set receiver and body coil transmitter gain parameters to optimize image S/N for each scan station. Additionally, the computer can adjust the acquisition matrix size or image field-of-view (FOV) at each station to optimize the image resolution on a per station basis.
Another feature of the preferred embodiment, is that once the bolus is introduced into the patient, the scan can be triggered using automatic bolus detection and triggering to assist in setting up the scan for the first scan station. After data acquisition of the first scan station, the computer can initiate movement of the patient table to the next station and select the appropriate receivers and adjust the transmitter and receiver gain settings appropriate for that particular scan station. This procedure is then repeated for each of the pre-programmed scan stations. In addition, by using a test bolus to determine the maximum imaging time available at each station, the MR data acquired is optimized to effectively visualize the arterial phase. The time available is used to acquire as many k-space lines as possible in each station before having to move to a subsequent station, with the central (low spatial frequency) k-space encoding lines acquired initially. It is noted that once sufficient k-space lines are acquired, or data acquisition at a particular station is complete, the system is capable of returning to a previous station to acquire additional k-space lines if time allows, or moving to a next station to acquire MR data, using the necessary table motion parameters and activation of the appropriate RF coil elements.
It is further noted that in peripheral run-off MRA, it is desired to image the peripheral arterial vasculature from the aorta at or above the level of the renal arteries, down to the lower extremities, including the feet. The present invention, as herein described, can also be used for a comprehensive assessment of the aorta, including the thoracic aorta, the abdominal aorta, and the aortoilliac segment. Where conventional MR imaging systems typically provide a maximum of 40-48 cm. image FOV, the present invention provides an effective imaging region of approximately 100-150 cm. FOV.
Various other features, objects and advantages of the present invention will be made apparent from the following detailed description and the drawings.
BRIEF DESCRIPTION OF THE DRAWINGSThe drawings illustrate the best mode presently contemplated for carrying out the invention.
In the drawings:
FIG. 1 is a schematic diagram showing basic components of an MR system for use in practicing embodiments of the invention.
FIG. 2 is a schematic diagram illustrating an arrangement for conducting a peripheral MR angiography exam, in accordance with the invention.
FIG. 3 is a flow chart illustrating an embodiment of the invention.
FIG. 4 is a flow chart illustrating an embodiment of the invention.
FIG. 5 is a block diagram of an embodiment of the invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTReferring to FIG. 1, a magnetic resonance (MR)imaging system8 of a type suitable for the practice of the invention includes acomputer10 which controls gradientcoil power amplifiers14 through apulse control module12. Thepulse control module12 and thegradient amplifiers14 together produce the proper gradient waveforms Gx, Gy, and Gz, for either a spin echo, a gradient recalled echo pulse sequence, a fast spin echo, or other type of pulse sequences. The gradient waveforms are connected to gradient coils16 which are positioned around the bore of themagnet34 so that gradients Gx, Gy, and Gz are impressed along their respective axes on the polarizing magnetic field Bo frommagnet34.
Thepulse control module12 also controls aradio frequency synthesizer18 which is part of an RF transceiver system, portions of which are enclosed by dashedline block36. Thepulse control module12 also controls anRF modulator20 which modulates the output of theradio frequency synthesizer18. The resultant RF signals, amplified bypower amplifier22 and applied toRF coil26 through transmit/receiveswitch24, are used to excite the nuclear spins of the imaged object (not shown).
The MR signals from the excited nuclei of the imaged object are picked up by theRF coil26 and presented topreamplifier28 through transmit/receiveswitch24, to be amplified and then processed by aquadrature phase detector30. The detected signals are digitized by a high speed A/D converter32 and applied tocomputer10 for processing to produce MR images of the object.Computer10 also controls shimmingcoil power supplies38 to power shimmingcoil assembly40.
The present invention includes a method and system for MRI angiography for use with the above-referenced MRI system, or any similar or equivalent system for obtaining MR images.
Referring to FIG. 2, apatient50 is shown supported on a computer controlled, movable table52, which may be slid or translated fore and aft as indicated byarrow54 in themagnet34 ofMR apparatus8. Thus,patient50 may be selectively positioned within the bore ofmain magnet34. The motion of the table is under computer control whose position alongaxis54 of the magnet bore can be precisely controlled and is reproducible.
More specifically, FIG. 2 showspatient50 having a blood vessel64 of substantial length, such as the aorta, femoral arteries, or other artery, extending from the abdominal area into the lower limbs of the subject. It is desirable to acquire MR image data of vessel64 in its entirety. However, because of the substantial length of vessel64, it is necessary to obtain the data by establishing a plurality of scan locations orstations56,58,60 along the length ofpatient50 and within components of the MR system. Eachscan station56,58 includes a pre-defined section ofpatient50. For example, scanstation56 includes the upper trunk area ofpatient50,scan station58 includes the lower trunk area, andscan station60 includes the lower extremities ofpatient50. To acquire MR data associated with a particular scan station, movable table52 is moved fore and aft alongaxis54 to position the particular scan station in a specified relationship with themain magnet34. For example, FIG. 2 shows the midpoint ofscan station56 positioned atisocenter62 ofmagnet34.
In a conventional arrangement, an entire set of MR data pertaining to the segment of vessel64, lying withinscan station56, would be acquired while such scan station was in the position shown in FIG.2. Then, table52 would translatepatient50 leftward, as viewed in FIG. 2, to position the midpoint ofscan station58 atisocenter62. After scanning an entire set of data pertaining to the segment of vessel64 withinscan station58,patient50 would be further translated, to position the midpoint ofscan station60 atisocenter62. A set of MR data pertaining to scanstation60 would then be scanned to complete the data acquisition procedure. It is noted that a certain amount ofover-lap66,68 may occur between adjacent scan stations. This is both desired and needed to enable the effective combination of images from each station into a single combined image covering the entire extent of the imaged region from all stations.
It is common practice in MR angiography to intravenously inject a contrast agent, such as 20-40cc of gadolinium chelate, into blood70 flowing through vessel64 which provides abolus72 to flow through the blood stream70. Since vessel64 carries blood from the upper body to the lower limbs ofpatient50, the flow direction is from left to right, as viewed in FIG.2. After reaching thepulmonary system74, thebolus72 would arrive first atscan station56, then arrive atscan station58, and finally arrive atscan station60.
In accordance with a conventional technique by the General Electric Company known commercially as SMARTPREP™ and as described in detail in Automated Detection of Bolus Arrival and Initiation of Data Acquisition in Fast, Three Dimensional, Gadolinium-Enhanced MR Angiography, by Foo T. K. L.; Saranathan M; Prince MR; Chenevert T L, inRadiology1997; 203:273-280, amonitor76 is placed in close proximity to vessel64 and upstream of the arterial blood flow for the field-of-view that constitutesscan station56, an example of which is shown in FIG.2. The precise positioning ofmonitor76 is not critical, but preferably, it is positioned within the first 25% of the relevant scan station. Themonitor76 periodically detects MR signal excited in a small volume or region of vessel64. The detected MR signal will reach a specified threshold level when the contrast agent enters that portion or segment of vessel64 lying withinscan station56, at which time scanning ofstation56 commences. When the scan is complete, the MR apparatus will sequentially proceed to acquire data from thesubsequent scan stations58 and60.
As previously indicated, in prior art MRA techniques, the time required for thebolus72 to travel from one scan station to the next has not been known, and since it varies from patient to patient, it would be advantageous to know such travel time. In the past, this could significantly diminish the benefits of using a contrast agent in conventional scan techniques or require the use of increased quantities or dosages of gadolinium chelate contrast material. Thus, in order to overcome such disadvantages in the prior art, and in accordance with one embodiment of the present invention, monitors78 and80 are directed toward vessel64 inscan stations58 and60.Monitors78 and80 can then detect the arrival ofbolus72 withinscan stations58 and60, respectively. The operation and construction ofmonitors78 and80 is similar to that ofmonitor76.
According to the present invention, there are two main algorithms to complete an MR image acquisition according to the preferred embodiment. The first, as shown in FIG. 3, is a test bolus traveltime determination algorithm82, and the second, is theMR image acquisition84, as shown in FIG. 4, using the test bolus travel timing determination of FIG.3.
Referring to FIG. 3, the first step in the test bolus traveltiming determination algorithm82 afterstartup86 is to obtain monitor volume positions and baseline data for allscan stations88. Baseline data is obtained from each monitor prior to acquisition of image data of the angiography exam in the absence of contrast agent. From such data, a threshold level may be reset for each monitor to indicate arrival of the bolus at the corresponding scan stations. These localized scans are typically referred to as scout views. The system is then reset to the first scan station and the test bolus is started92 by injecting a small amount of contrast agent, typically 1-5 ml, injected at the same flow rate as a regular exam bolus. The test bolus begins to pass through the patient's peripheral vasculature as the algorithm records the start time and beginsbolus monitoring94. It is noted that themonitor volume76,78, and80 can be located anywhere within the image field-of-view within each station, and preferably, can be placed exactly over the area of interest within the desired field-of-view. At which time the MR signal monitored is compared against apreset threshold96, and if the monitored signal does not exceed thepreset threshold98, the bolus monitoring continues at94. When the monitored signal exceeds thepreset threshold100, the time at which the bolus is detected for that scan station is stored102. The patient table is moved to a next, or subsequent, scan station as long as the current scan station is not the last predefined scan.
The monitor volume is then adjusted to acquire data at the nextmonitor volume location108, at which time the system returns to begin bolus monitoring and recording the start time of that particular monitor volume at94, and then continues to loop and acquire the travel time of the test bolus through each of the given number of scan stations until the last scan station is detected at104,110. The time available for acquiring imaging at a regular exam bolus, is then stored for each station as Tavailat112 and the system is then ready for regularMR image acquisition114.
Referring to FIG. 4, theimage acquisition algorithm84 is shown, and afterinitialization116, the monitor volume positions and baseline data for all scan stations are acquired118. The system is then reset and the patient table is moved back to thefirst scan station120 and the regular exam bolus is injected into thepatient122. Bolus monitoring is then commenced124 while monitoring the monitor volume for the first scan station. The monitored signal is compared against thepreset threshold126, and if it does not exceed thepreset threshold128, the monitor rechecks for the presence of thebolus124 until the monitored signal exceeds thepreset threshold130, at which time, the timer (tn) is activated132 and the MR apparatus beginsimage acquisition134, starting primarily with the acquisition of central k-space data. The timer for that particular station is then compared to the testbolus travel time136, and as long as the current data acquisition time is less than the testbolus travel time138, and data acquisition is not yet complete140,142, the system continues to acquiredata144. Once either the data acquisition time for this particular scan station equals or exceeds the testbolus travel time136,146, or the system has acquiredsufficient data140,148, the patient table is adjusted to the next scan station as long as the system is not currently at thelast scan station150,152. After which, the system switches to acquire data at the nextmonitor volume location154 and begins the bolus monitoring again at124. The system then loops, as described, until data is acquired or the system times out for thelast scan station156. The system then returns to any scan station in which a full k-space data set had not been acquired, and acquires the missing k-space data158. Once all k-space data is acquired for all the scan stations, the image acquisition algorithm is concluded160.
While FIG. 2 shows threescan stations56,58 and60, it is readily apparent that in other embodiments, the number of scan stations n may be greater or less than that shown in the preferred embodiment. Moreover, as is readily apparent from FIG. 4, the initial data acquisition at each scan station is described as being limited to acquiring central k-space data, that is, the k-space data of low spatial frequencies. This acquisition can be expanded to acquire higher spatial frequency k-space data if time permits. However, it is recognized that the lower spatial frequency k-space data is the most significant in image reconstruction, and can be usefully acquired in approximately 5-10 seconds.
FIG. 5 shows a functional block diagram ofcomputer10 connected toMRI apparatus8, as shown in FIG. 1, and to the movable patient table52. The control has aninput170 that may be used for indicating the start of a test bolus and/or the exam bolus to thebolus detection172. Additionally, or alternatively, bolus detection can be accomplished by the aforementioned monitor volume procedure, one example of which is the aforementioned commercially available SMARTPREP™ from the General Electric Company. Thestorage device174 is connected to thebolus detection172 and receives preset thresholds for comparing the monitored signal from the monitor volume. The preset thresholds are compared to the monitored signals in asignal comparator176, the output of which is used in anMRI acquisition control178, together with the output of atimer180, to check the location of the bolus usingMRI apparatus8. TheMRI acquisition control178 also is connected to ascan station control182 which controls patient table52 throughtable motion control184. Thescan station control182 is also connected to thebolus detection172 in order to reset the patient table to the first scan station when a procedure is first initialized.Timer180 is also connected tostorage device174 to store the maximum travel time that it takes the test bolus to travel through a given scan station.Timer180 is also connected between a signal compared to176 and theMRI acquisition control178 and is used during image acquisition to time the current MRI acquisition and compare it intime comparator186 with the maximum test bolus travel time as retrieved from thestorage device174. To optimize image acquisition, the stored values for the test bolus travel time, for each scan station, are used in theMRI acquisition control178 to select the most desirable coil elements inMRI apparatus8 and to set the optimal receiver and body coil transmitter gain parameters inMRI apparatus8.
Accordingly, the invention includes an MR imaging system for imaging a patient's peripheral vasculature that includes a means for acquiringMR images8 and a means for tracking atest bolus172 through a series of scan stations located along the patients' vasculature. A means for selectively positioning apatient184,52, in a desired scan station, and within the means for acquiringMR images8 is responsive to the means for tracking thetest bolus172. Additionally, a means for determining and storing amaximum travel time174,180,186 of the test bolus through each scan station, is used together with a control means174, for acquiring MR images during the maximum travel time for each scan station.
The MR imaging system of the invention also includes a means for retrieving themaximum travel time174,186 and thetimer180 is used to track MR image acquisition time. Acomparator186 is used to compare the MR image acquisition time to the maximum travel time. The control means178 first acquires central k-space MR data within the maximum travel time, then, if the maximum travel time has not expired, the control means178 acquires higher spatial frequency MR data for the remaining time. The system also includes a means for acquiringmonitor volume data172 within each scan station and initiating the tracking of the test bolus and the response thereto. The MR imaging system also includes a means for selecting only a desired number ofcoils188 and setting coil transmitter gain parameters in the means for acquiringMR images8, in response to the position of the patient and the desired scan station, together with the maximum travel time of the test bolus through that particular scan station, for prescanning and acquiring a monitored signal indicative of a bolus presence.
The present invention has been described in terms of the preferred embodiment, and it is recognized that equivalents, alternatives, and modifications, aside from those expressly stated, are possible and within the scope of the appending claims.